Introduction: Increased adiposity has been associated with smoldering systemic inflammation and metabolic syndrome manifestations, leading to further morbidity by increasing the risk for type 2 diabetes mellitus and cardiovascular disease in adults. Similar analyses have not been performed systematically in children and adolescents.
Hypothesis: This study investigates the interrelations between body composition parameters and indices of inflammation and metabolic syndrome.
Methods: One hundred twenty-one normal weight (40), overweight (22) and obese (59) children and adolescents (43 boys and 78 girls) were studied: Normal weight BMI z-score −0.1923±0.6, Overweight BMI z-score 0.922±0.4 and obese BMI z-score 2.669±1.3 children aged 515 years. Medical history, physical examination and anthropometry were obtained by a certified pediatrician. Body composition analysis was performed using an advanced bioimpedance apparatus (BIA-ACC, Biotekna Co, Venice, Italy) and fasting blood samples were withdrawn for measuring serum inflammatory and metabolic markers.
Results: Body fat mass (BFM) both as an absolute value in Kg and as a percentage of body mass was positively associated with morning fasting insulin (P=0.000 and P=0.000 respectively), hsCRP (P=0.000 and P=0.000, respectively), ferritin (P=0.014 and P=0.002, respectively), uric acid (P=0.000 and P=0.000 respectively), triglycerides (P=0.000 and P=0.000, respectively), SGPT (P=0.042 and P=0.006, respectively) and γGT(P=0.000 and P=0.000, respectively) concentrations. BFM as an absolute value in Kg and as a percentage was negatively associated with high density lipoprotein (P=0.002 and P=0.000, respectively) and iron (P=0.002 and P=0.000, respectively) concentrations. Extracellular water percentage was positively associated with insulin (P=0.000) and hsCRP (P=0.011), while skeletal muscle mass both as an absolute value in Kg and as a percentage (%) of body mass were also respectively associated with insulin (P=0.000 and P=0.000) and hsCRP (P=0.05 and P=0.009) concentrations. Moreover, insulin levels correlated positively with glucose levels estimated by the BIA-ACC apparatus (P=0.000). All the above statistical analyses are adjusted for sex and Tanner pubertal stages.
Conclusion: Body fat accumulation in children is associated with elevated inflammatory and metabolic syndrome markers. Bioelectric impedance can be a direct screening and monitoring tool for the assessment of metabolic disorders in children and adolescents. Further studies are needed to evaluate the pathophysiologic mechanisms mediating these effects in children.
27 - 29 Sep 2018
European Society for Paediatric Endocrinology